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i asked an older cancer patient of mine
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to draw a clock for me He got frustrated
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about why the test is needed I explained
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to him and I will explain to you Hi this
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is Dr Army Sharney a geriatric
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oncologist I have 12 years of experience
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of taking care of thousands of older
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The clock drawing test is a cognitive
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screening tool It's been used for many
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years in fact since 2000 It is quick and
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easy to administer and that's why many
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clinicians like it We ask you to draw a
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clock then put the numbers in and then
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put the hands in a way that it shows 10
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11 It seems easy and straightforward but
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Let's go over the process one by
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one I tell you that I want you to draw a
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clock for me with this simple
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instruction One we are testing your
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hearing You need to be able to hear
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Second you need to have enough attention
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span that is a clock and likely other
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instruction will come after Third you
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need to comprehend the instruction which
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Then you will draw a clock starting by
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drawing a circle That circle could be
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very small or that circle could be very
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large or it could be of a normal
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size We also pay attention to your
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shaking Did you more or less draw a face
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of the clock or it was something
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else Then we asked to put the numbers in
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Here we are testing your executive
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planning You need to put the numbers
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like a normal clock We're also testing
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your visual spatial ability and ability
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to put the numbers within a relatively
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similar distance from each other and
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reach 12 at the end Now some patients do
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perfectly How They first put 12 then
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three then six then nine and then they
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fill the rest of the numbers in each
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section In some cases the patient
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continues to put the numbers in without
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paying attention to the normal form of a
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clock In some cases the patient puts all
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the numbers in one half of the clock And
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in some other cases patient starts by
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putting the numbers correctly and then
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mistakes After putting the numbers in we
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ask you to put the hands in a way that
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11 Why we ask it that way Because now
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the patient must analyze which hand has
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to point to what number Should the long
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11 And then what about the short hand
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The clock is supposed to show 10 11 So
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does that mean that the short hand
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should point to 10 or
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two As you see a clock drawing is not a
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simple task Many times patients get
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frustrated because they think they are
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unable to do a simple
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task But the reality is a clock drawing
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involves multiple domains of your brain
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Now it's important to mention few very
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important points Your ability to draw a
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clock might be impacted by a variety of
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factors unrelated to your cognitive
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function Let's say you're extremely
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anxious or you're just diagnosed with
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cancer and there are so many things in
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your mind As a result paying attention
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to a proper clock drawing is not your
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priority Second it's important for the
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care providers to explain the importance
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test So so you try to pay as much as
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attention as possible Third clock
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drawing test is just a cognitive
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screening We are not diagnosing you with
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cognitive impairment if you fail the
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test The most important utility of this
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test for you and the family is to know
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that there might be some degree of
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impairment and more comprehensive
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testing might be needed especially if
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it's aligned with your goals
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So in summary don't assume clock drawing
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is easy Don't be frustrated if your
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clock drawing is not perfect Don't be
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alarmed by an abnormal clock especially
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if you continue to manage your daily
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perfectly And think with
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yourself when was the last time that you
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presented to your cardiologist and
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cardiologist did a test and found out
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that you might be at risk for future
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attacks When you come to a geriatrician
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clock drawing is a test that may help
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you and the family in the future by
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seeking care sooner rather than
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later If you enjoy this video I
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appreciate if you like my video
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subscribe to this channel leave a
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comment below and the goal is to provide
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global geriatric education for the
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global aging population See you in the
